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The i2b2 Temporal Data-Mining Solution for Automated Reconstruction of Different Breast Cancer Patterns of Care over a Decade of Observation

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Alberto Zambelli, Flavia Jacobs*, Arianna Ghirardi, Lorenzo Chiudinelli, Mauro Bucalo, Nicola Barbarini, Sara Du2019Alessandro3, Arianna Masciulli, Vittoria Fotia, Riccardo Bellazzi and Carlo Tondini

Volume5-Issue6
Dates: Received: 2024-06-14 | Accepted: 2024-06-21 | Published: 2024-06-21
Pages: 630-639

Abstract

Background: In oncology, Patterns of Care (PoC) provide a detailed overview of all cancer-treatment interventions and recapitulate the entire patient’s journey. While manual-chart PoC reviewing is time-consuming, the use of Electronic Health Records (EHRs) enables the creation of data-mining solutions to automatically reconstruct the whole cancer trajectory with different granularity.

Methods: We tested the ability of the i2b2 (Informatics for Integrating Biology and Bedside) solution to support the automatic reconstruction of the PoC for consecutive and unselected HER2+ and TNBC breast cancer patients through a retrospective EHRs analysis over a decade of observations.

Results: From 2008 to 2017, 561 HER2+ and 412 TNBC patients were retrospectively identified by i2b2 platform at the Papa Giovanni XXIII Hospital in Bergamo. Most patients, 74.3% in the HER2 group and 71.8% in the TNBC group, received a (neo) adjuvant chemotherapy, with anti-HER2 drugs whenever indicated. Among the HER2 cohort, the 5-year Time to Treatment Change (TTC) and Overall Survival (OS) were 69.4% and 77.4% respectively, with 25% of patients receiving up to 3 lines of treatment in metastatic setting. Among the TNBC cohort, the 5-year TTC and OS were 59.3% and 69.4% respectively, with only 2% of patients receiving active treatment as third line of therapy. The consistency of the automated PoC reconstruction had to be reviewed in 1/3 of cases to clean conflicting data.

Conclusion: The i2b2 solution has the potential to provide a retrospective, automated reconstruction of the different PoC, with limited manual-chart review refinement and might contribute to support investigations in the field of real-world data.

FullText HTML FullText PDF DOI: 10.37871/jbres1935


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Copyright

© 2024 Zambelli A, et al. Distributed under Creative Commons CC-BY 4.0

How to cite this article

Zambelli A, Jacobs F, Ghirardi A, Chiudinelli L, Bucalo M, Barbarini N, D’Alessandro S, Masciulli A, Fotia V, Bellazzi R, Tondini C. The i2b2 Temporal Data-Mining Solution for Automated Reconstruction of Different Breast Cancer Patterns of Care over a Decade of Observation. J Biomed Res Environ Sci. 2024 Jun 21; 5(6): 630-639. doi: 10.37871/jbres1935, Article ID: JBRES1935, Available at: https://www.jelsciences.com/articles/jbres1935.pdf


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References


  1. Wong W. The evolution of clinical pathways for oncology. J Clin Pathw. 2015.
  2. Chiang AC, Ellis P, Zon R. Perspectives on the Use of Clinical Pathways in Oncology Care. Am Soc Clin Oncol Educ Book. 2017;37:155-159. doi: 10.1200/EDBK_175533. PMID: 28561702.
  3. Fasola G, Barducci MC, Tozzi VD, Cavanna L, Cinieri S, Perrone F, Pinto C, Russo A, Sapino A, Grossi F, Aprile G. Implementation of Precision Oncology in the National Healthcare System: A Statement Proposal Endorsed by Italian Scientific Societies. JCO Precis Oncol. 2023 Sep;7:e2300166. doi: 10.1200/PO.23.00166. PMID: 37944071; PMCID: PMC10645411.
  4. Fasola G, Macerelli M, Follador A, Rihawi K, Aprile G, Della Mea V. Health information technology in oncology practice: a literature review. Cancer Inform. 2014 Dec 1;13:131-9. doi: 10.4137/CIN.S12417. PMID: 25506195; PMCID: PMC4254653.
  5. Rotenstein LS, Holmgren AJ, Healey MJ, Horn DM, Ting DY, Lipsitz S, Salmasian H, Gitomer R, Bates DW. Association Between Electronic Health Record Time and Quality of Care Metrics in Primary Care. JAMA Netw Open. 2022 Oct 3;5(10):e2237086. doi: 10.1001/jamanetworkopen.2022.37086. PMID: 36255725; PMCID: PMC9579903.
  6. Post AR, Burningham Z, Halwani AS. Electronic Health Record Data in Cancer Learning Health Systems: Challenges and Opportunities. JCO Clin Cancer Inform. 2022 Mar;6:e2100158. doi: 10.1200/CCI.21.00158. PMID: 35353547; PMCID: PMC9005105.
  7. Tarver WL, Menachemi N. The impact of health information technology on cancer care across the continuum: a systematic review and meta-analysis. J Am Med Inform Assoc. 2016 Mar;23(2):420-7. doi: 10.1093/jamia/ocv064. Epub 2015 Jul 15. PMID: 26177658; PMCID: PMC5009923.
  8. Dagliati A, Sacchi L, Zambelli A, Tibollo V, Pavesi L, Holmes JH, Bellazzi R. Temporal electronic phenotyping by mining careflows of breast cancer patients. J Biomed Inform. 2017 Feb;66:136-147. doi: 10.1016/j.jbi.2016.12.012. Epub 2017 Jan 3. PMID: 28057564.
  9. Murphy SN, Mendis ME, Berkowitz DA, Kohane I, Chueh HC. Integration of clinical and genetic data in the i2b2 architecture. AMIA Annu Symp Proc. 2006;2006:1040. PMID: 17238659; PMCID: PMC1839291.
  10. McMurry AJ, Gilbert CA, Reis BY, Chueh HC, Kohane IS, Mandl KD. A self-scaling, distributed information architecture for public health, research, and clinical care. J Am Med Inform Assoc. 2007 Jul-Aug;14(4):527-33. doi: 10.1197/jamia.M2371. Epub 2007 Apr 25. PMID: 17460129; PMCID: PMC2244902.
  11. Murphy SN, Weber G, Mendis M, Gainer V, Chueh HC, Churchill S, Kohane I. Serving the enterprise and beyond with informatics for integrating biology and the bedside (i2b2). J Am Med Inform Assoc. 2010 Mar-Apr;17(2):124-30. doi: 10.1136/jamia.2009.000893. PMID: 20190053; PMCID: PMC3000779.
  12. Gennari A, André F, Barrios CH, Cortés J, de Azambuja E, DeMichele A, Dent R, Fenlon D, Gligorov J, Hurvitz SA, Im SA, Krug D, Kunz WG, Loi S, Penault-Llorca F, Ricke J, Robson M, Rugo HS, Saura C, Schmid P, Singer CF, Spanic T, Tolaney SM, Turner NC, Curigliano G, Loibl S, Paluch-Shimon S, Harbeck N; ESMO Guidelines Committee. Electronic address: [email protected]. ESMO Clinical Practice Guideline for the diagnosis, staging and treatment of patients with metastatic breast cancer. Ann Oncol. 2021 Dec;32(12):1475-1495. doi: 10.1016/j.annonc.2021.09.019. Epub 2021 Oct 19. PMID: 34678411.
  13. Giordano SH, Franzoi MAB, Temin S, Anders CK, Chandarlapaty S, Crews JR, Kirshner JJ, Krop IE, Lin NU, Morikawa A, Patt DA, Perlmutter J, Ramakrishna N, Davidson NE. Systemic Therapy for Advanced Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: ASCO Guideline Update. J Clin Oncol. 2022 Aug 10;40(23):2612-2635. doi: 10.1200/JCO.22.00519. Epub 2022 May 31. PMID: 35640077.
  14. Gradishar WJ, Moran MS, Abraham J, Abramson V, Aft R, Agnese D, Allison KH, Anderson B, Burstein HJ, Chew H, Dang C, Elias AD, Giordano SH, Goetz MP, Goldstein LJ, Hurvitz SA, Jankowitz RC, Javid SH, Krishnamurthy J, Leitch AM, Lyons J, Mortimer J, Patel SA, Pierce LJ, Rosenberger LH, Rugo HS, Schneider B, Smith ML, Soliman H, Stringer-Reasor EM, Telli ML, Wei M, Wisinski KB, Young JS, Yeung K, Dwyer MA, Kumar R. NCCN Guidelines® Insights: Breast Cancer, Version 4.2023. J Natl Compr Canc Netw. 2023 Jun;21(6):594-608. doi: 10.6004/jnccn.2023.0031. PMID: 37308117.
  15. Cardoso F, Senkus E, Costa A, Papadopoulos E, Aapro M, André F, Harbeck N, Aguilar Lopez B, Barrios CH, Bergh J, Biganzoli L, Boers-Doets CB, Cardoso MJ, Carey LA, Cortés J, Curigliano G, Diéras V, El Saghir NS, Eniu A, Fallowfield L, Francis PA, Gelmon K, Johnston SRD, Kaufman B, Koppikar S, Krop IE, Mayer M, Nakigudde G, Offersen BV, Ohno S, Pagani O, Paluch-Shimon S, Penault-Llorca F, Prat A, Rugo HS, Sledge GW, Spence D, Thomssen C, Vorobiof DA, Xu B, Norton L, Winer EP. 4th ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 4)†. Ann Oncol. 2018 Aug 1;29(8):1634-1657. doi: 10.1093/annonc/mdy192. PMID: 30032243; PMCID: PMC7360146.
  16. Leon-Ferre RA, Goetz MP. Advances in systemic therapies for triple negative breast cancer. BMJ. 2023 May 30;381:e071674. doi: 10.1136/bmj-2022-071674. PMID: 37253507.
  17. Bianchini G, De Angelis C, Licata L, Gianni L. Treatment landscape of triple-negative breast cancer - expanded options, evolving needs. Nat Rev Clin Oncol. 2022 Feb;19(2):91-113. doi: 10.1038/s41571-021-00565-2. Epub 2021 Nov 9. PMID: 34754128.
  18. I2b2: Informatics for integrating biology & the bedside. 2024.
  19. Murphy S, Wilcox A. Mission and Sustainability of Informatics for Integrating Biology and the Bedside (i2b2). EGEMS (Wash DC). 2014 Sep 11;2(2):1074. doi: 10.13063/2327-9214.1074. PMID: 25848608; PMCID: PMC4371505.
  20. Swain SM, Miles D, Kim SB, Im YH, Im SA, Semiglazov V, Ciruelos E, Schneeweiss A, Loi S, Monturus E, Clark E, Knott A, Restuccia E, Benyunes MC, Cortés J; CLEOPATRA study group. Pertuzumab, trastuzumab, and docetaxel for HER2-positive metastatic breast cancer (CLEOPATRA): end-of-study results from a double-blind, randomised, placebo-controlled, phase 3 study. Lancet Oncol. 2020 Apr;21(4):519-530. doi: 10.1016/S1470-2045(19)30863-0. Epub 2020 Mar 12. PMID: 32171426.
  21. Verma S, Miles D, Gianni L, Krop IE, Welslau M, Baselga J, Pegram M, Oh DY, Diéras V, Guardino E, Fang L, Lu MW, Olsen S, Blackwell K; EMILIA Study Group. Trastuzumab emtansine for HER2-positive advanced breast cancer. N Engl J Med. 2012 Nov 8;367(19):1783-91. doi: 10.1056/NEJMoa1209124. Epub 2012 Oct 1. Erratum in: N Engl J Med. 2013 Jun 20;368(25):2442. PMID: 23020162; PMCID: PMC5125250.
  22. Tutt A, Tovey H, Cheang MCU, Kernaghan S, Kilburn L, Gazinska P, Owen J, Abraham J, Barrett S, Barrett-Lee P, Brown R, Chan S, Dowsett M, Flanagan JM, Fox L, Grigoriadis A, Gutin A, Harper-Wynne C, Hatton MQ, Hoadley KA, Parikh J, Parker P, Perou CM, Roylance R, Shah V, Shaw A, Smith IE, Timms KM, Wardley AM, Wilson G, Gillett C, Lanchbury JS, Ashworth A, Rahman N, Harries M, Ellis P, Pinder SE, Bliss JM. Carboplatin in BRCA1/2-mutated and triple-negative breast cancer BRCAness subgroups: the TNT Trial. Nat Med. 2018 May;24(5):628-637. doi: 10.1038/s41591-018-0009-7. Epub 2018 Apr 30. PMID: 29713086; PMCID: PMC6372067.
  23. Nuzzolese I, Montemurro F. Attrition in metastatic breast cancer: a metric to be reported in randomised clinical trials? Lancet Oncol. 2020 Jan;21(1):21-24. doi: 10.1016/S1470-2045(19)30792-2. PMID: 31908294.
  24. Bastião Silva LA, Días C, van der Lei J, Oliveira JL. Architecture to Summarize Patient-Level Data Across Borders and Countries. Stud Health Technol Inform. 2015;216:687-90. PMID: 26262139.
  25. Huang Z, Lu X, Duan H. On mining clinical pathway patterns from medical behaviors. Artif Intell Med. 2012 Sep;56(1):35-50. doi: 10.1016/j.artmed.2012.06.002. Epub 2012 Jul 17. PMID: 22809825.
  26. Zhang Y, Padman R, Wasserman L, Patel N, Teredesai P, Xie Q. On clinical pathway discovery from electronic health record data. IEEE Intell Syst. 2015;30:70-5. doi: 10.1109/MIS.2015.14.
  27. Hong D, Yokoya N, Xia GS, Chanussot J, Zhu XX. X-Modalnet: A semi-supervised deep cross-modal network for classification of remote sensing data. ISPRS J Photogramm Remote Sens. 2020;167:12-23. doi: 10.1016/j.isprsjprs.2020.06.014.
  28. Chang S, Deng Y, Zhang Y, Wang R, Qiu J, Wang W, Zhao Q, Liu D. An advanced echo separation scheme for space-time waveform-encoding SAR based on digital beam forming and blind source separation. Remote Sens. 2022;14(15):3585. doi: 10.3390/rs14153585.
  29. Liu D, Chang S, Deng Y, He Z, Wang F, Zhang Z, Han C, Yu C. A Novel spaceborne SAR constellation scheduling algorithm for sea surface moving target search tasks. IEEE J Sel Top Appl Earth Obs Remote Sens. 2024;17:3715-26.


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